A COMPARATIVE STUDY BETWEEN HAEMODYNAMIC VARIABILITY AND AMOUNT OF SEVOFLURANE CONSUMPTION WITH COST ANALYSIS.

Md. Shafiqul Islam*, Md. Arif Uddin, Md. Abdur Rahim, Kazi Mahzabin Arin, Raka Mustary Khan, AKM Akhtaruzzaman

ABSTRACT

Objective: The Objective of the study was to compare between haemodynamic variability and amount of sevoflurane consumption with cost analysis. Method: This double blinded randomized clinical trial was conducted among 120 patients aged 1-7 years undergoing routine elective paediatric day case surgery of under 60 minutes of duration at the Department of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU, Dhaka during the period of May 2018 to september 2018. Results: Majority patients were male (92.5%). Among group A patients, 90% were male and 10% were female. Whereas, among group B patients, 95% were male and 5% were females. Distribution of sex was similar across groups (p>0.05). Among all patients, majority belonged to ASA grade I (91.7%). Among group A patients, 93.3% were of ASA grade I and 6.7% were of grade II. Among group B patients 90% were of grade I and 10 % were of grade II. There were no statistically significant difference between groups (p>0.05). Peri-operative heart rate and blood pressure were significantly lower in group B patients in comparison to group A patients. Recovery profile was measured by modified Ramsay Sedation Score. Total volume percentage of anaesthetic gas required and mean volume percentage per min were significantly higher in Group A than group B (p<.001). Total volume of sevoflurane consumed, total cost of sevoflurane and per minute cost of sevoflurane were significantly lower in patients who were given midazolam as a premedication (group B) than those who were not given midazolam premedication (group A, p<.001 for each). The concentration of sevoflurane required during maintenance of anaesthesia was less. So total amount of sevoflurane was less required in experimental group. Adding the cost of oral midazolam tablet will contribute very insignificantly to the total cost. Conclusion: From our study we can say that premedication with midazolam provided better reduction in peri-operative anxiety, lesser consumption of sevoflurane in paediatric day case surgery with lower cost in these group compared to control.

Keywords: Haemodynamic, anaesthesia, sevoflurane, midazolam.